Republicans are cruel to cut Medicaid especially when children's growth, development and health care is on the chopping block

Echo a "national" opinion published in the Anchorage Daily News by By Dominique Dagdag

Opinion: Cutting Medicaid harms kids and America’s future

As a pediatric resident in Texas, I have seen how important Medicaid is for my patients and their ability to access the care they need to thrive, and what can happen when there are gaps in that care.

Recently, I saw a child in clinic for her well-child visit. I noticed that she did not reach all her developmental milestones, although she had been on track in previous visits.

It was then that her family disclosed that she lost her Medicaid insurance, so she was no longer able to attend her therapy sessions that helped her advance in school. She had to repeat the 2nd grade, and now her parents are worried that she might be held back again without the therapies Medicaid was providing her to succeed.

I treated another child in the hospital with a bump on his leg after a fall. Initially, it was thought that the bump was caused by the injury. However, after several weeks, the bump did not heal and became extremely painful — so severe that he refused to walk. He was not acting like the active toddler his family knew. His usual smiles and giggles turned into tears and agitation.

After extensive testing, he was diagnosed with a rare childhood cancer. Since he was covered by Medicaid, he was able to quickly connect with oncologists and start chemotherapy. If it was not for this life-saving insurance, he would not have survived.

These are only two stories of the 37 million U.S. children who are enrolled in Medicaid. In Texas, 74% of people enrolled in Medicaid are children, which is why cuts to Medicaid will disproportionately impact children. We know Medicaid is a program that works for children.

When children are enrolled in Medicaid, they are less likely to miss school due to health conditions, are more likely to earn their high school diploma, and are more likely to enter the workforce and contribute to the economy.

Starting with pregnancy, Medicaid provides benefits to both the mother and child. In Texas, Medicaid pays for 48% of births, which provides access to maternal, prenatal, and postpartum care.

Under Medicaid, children also have access to frequent well child visits, which could decrease their chances of developing chronic health conditions later on in life. In addition, if a child needs mental and behavioral health services, Medicaid is the largest federal funding source for this support. 

Medicaid has the powerful ability to provide care that is tailored to a child’s individual needs, helping a child grow into a healthy adult.

Pediatricians like me are alarmed about the Medicaid funding cuts under consideration in Congress for good reason❗ 

Cuts to Medicaid will harm children’s health. Their mothers will not have access to prenatal and maternal services that greatly contribute to maternal survival before, during, and after giving birth.

Medicaid plays a significant role in decreasing maternal mortality rates, and without healthy mothers, there would not be healthy infants. More adolescents will suffer from mental health disorders without available support covered by Medicaid. Children will no longer have access to vital resources such as medications that are essential to treat acute illnesses.

Multiple hospitals in Texas rely on Medicaid funding, particularly in our state’s rural areas, to keep their doors open. If these children’s hospitals shut down because of loss of revenue, it will impact all children, not just those covered by Medicaid.

Our nation’s children are our future. We must invest in children by keeping Medicaid strong. I urge lawmakers to reject funding cuts to Medicaid and protect the program for children in the state of Texas and across the country.

Dominique Dagdag, MD, is a pediatric resident physician in Texas. Her opinions are her own and not those of her employer. Distributed by Tribune News Service.

Maine Republican legislators have a lot of explaining to do: Yellow Flag law failed

Editorial echo published in the Boston Globe:

After Maine shootings, our grim ritual returns: burying the dead, pleading for better gun laws.  With some of the region’s most permissive firearm laws, Maine has been a poster child for the nation’s political paralysis on gun safety.

Congressman Jared Golden

There are two important, if crushingly familiar, early takeaways from the massacre of 18 people in Lewiston, Maine, on Wednesday evening, a death toll almost certain to rise. 

One is that the nation is facing a mental health crisis and has a critical shortage of mental health professionals to help it cope with that crisis.

The other is that it is far too easy to acquire firearms in Maine, particularly assault-style weapons whose main function is the swift and efficient killing of human beings, full stop.

Regarding the nation’s mental health crisis, there is much agreement across the political spectrum about the depth and breadth of the problem, as well as about the importance of doing more. 

Whether political leaders in Washington and state capitals can find the political will to allocate the required resources — and whether our educational institutions can recruit and train enough mental health caregivers — are works in progress.

But on the issue of imposing even the most common-sense restrictions on the powerful killing tools made by the firearms industry, the nation is hopelessly divided. Divided between liberals and conservatives, between rural areas and urban ones, even between men and women.

Maine is a poster child for the nation’s political paralysis on gun safety. Though the state government is controlled by the Democratic Party, the Legislature rejected a bounty of gun safety bills earlier this year, including a ban on rapid-fire devices, a 72-hour waiting period to purchase firearms and background checks for private gun sales.

Maine is among the nation’s most sparsely populated states — one where nearly half of adults have a gun at home and where hunting is a beloved pastime. That means that when it comes to gun issues, culture and geography may be as or even more important than party politics.

But once in a while, the hope of progress can rise from the ashes of tragedy. On Thursday, Representative Jared Golden, a Democrat from Lewiston who represents the vast northern half of Maine, declared that he had changed his mind about opposing a ban on assault weapons. In an emotional mea culpa, Golden, a former Marine infantryman who served in Iraq and Afghanistan, called his opposition to the ban “a failure” and pledged to work “with any colleague to get this done in the time that I have left in Congress.”

(Alas, Maine’s senior US senator, Susan Collins, said she would continue to oppose banning assault weapons. But Collins, a moderate Republican who played a constructive role in passage of a gun-safety measure in Congress last year, said she does support setting limits on high-capacity magazines, an incremental but valuable step.)

The real work, however, must start in Augusta. With the possible exception of Republican-dominated New Hampshire, Maine has the laxest gun laws in the Northeast. Currently, in Maine, there is little to stop, say, an abusive spouse from purchasing a semiautomatic weapon from an unlicensed dealer online or at a gun show because the state does not require background checks on private sales. Likewise, because the state does not have a waiting period on gun purchases, a person who is gripped by suicidal thoughts can walk into a gun store and purchase a handgun on the spur of the moment.

We still know little about the background and motives of the man accused in the Lewiston massacre, Robert R. Card II. An Army reservist, he was, according to various published reports, an expert marksman who, after living a quiet life on his family’s farm, struggled with mental health problems during the past year, including hearing voices at the bar and bowling alley where the killings occurred. Several outlets reported that he had received a mental health evaluation this summer due to “erratic” behavior and may have received treatment.

It also seems clear from surveillance photos that the man who killed or maimed all those people — those average Maine citizens who were innocently sipping beers or enjoying a night of bowling with friends — used a military-style assault rifle with its enhanced capability to rapidly fire more, and more lethal, rounds with the mere bending of a finger.

These details are sure to evolve as more reporting emerges. But huge questions remain. If in fact the suspect was hospitalized for mental health care, shouldn’t authorities have moved to have his firearms temporarily removed, as is allowed under the state’s so-called yellow flag law?

Gun safety advocates want to revise that law to make it simpler for family members to ask a judge to temporarily separate a person judged harmful to themselves or others from their firearms, as is allowed under stricter red flag laws that exist in 19 states. But one is left wondering whether anyone attempted to apply even the weaker yellow flag law to the alleged shooter. Did the alleged shooter’s family or Army Reserve colleagues even know it exists?

These are questions the Maine Legislature should begin debating. And a full range of laws, including a ban on high-capacity magazines and assault weapons, background checks on private sales, and a red flag law, should be on the table.

Opponents of gun safety laws will argue that, even with its lax laws, Maine has relatively little gun violence, that restrictions on gun ownership do not deter criminals, and that, well, the Second Amendment trumps all.

But suicide remains a major health issue in Maine, and nationally firearms are the most common means of killing oneself. Though the number of suicides declined last year from the previous year, the overall rate is well above two decades ago. And even the US Supreme Court, the most conservative and pro-gun court in decades, has said that some restrictions on gun ownership are constitutional.

Perhaps the most infuriating argument sure to come from gun rights activists is that most gun owners are law abiding and shouldn’t be put through the hassles and costs imposed by gun safety laws. They will also say that gun violence and mass shootings will occur with or without more restrictions.

The latter is of course true. But data show that the states with the lowest rates of gun fatalities — Hawaii and Massachusetts — also have among the most restrictive gun laws. And as to the former: Are we as a society prepared to say that inconveniences imposed on one group should outweigh the ability to save the lives of some, even a few, of our fellow citizens?

The choice should be clear.

Mental illness did not prevent the Lewiston shooter from getting access to multiple guns

Echo report published in The Maine Monitor by Samantha Hogan, David Dahl and Rose Lundy:

Mass shootings at a bowling alley and bar that left 18 people dead in Lewiston on Wednesday (October 25) evening have brought Maine’s complicated relationship with guns and how to regulate them to the forefront once again.

In the past three years, state lawmakers proposed nearly four dozen bills to regulate the sale, carry and liability of guns in Maine, but most have not passed the Legislature. A “yellow flag” law enacted in 2019, lets law enforcement take guns away from someone they suspect of posing a threat to themselves or others, but officials concede it is underutilized.

Maine ranks in the middle of the pack among other states when it comes to gun safety laws, according to Everytown for Gun Safety, a gun control group, and the laws in place appeared to have done little to stop the suspect in the mass shooting in Lewiston.

Maine does not require a permit to carry a firearm in most cases. State lawmakers have rejected proposals for background checks and limits on accessories that make guns more easy to shoot. It also does not have a ban on assault weapons, unlike two other New England states.

Kristen Cloutier (Democrat), who lives in Lewiston and is the Assistant House Majority Leader, said the shooting in her hometown was “surreal and heartbreaking,” and called for “bold” legislative action to address gun violence.

“This has only strengthened my own resolve to do whatever I can to help prevent similar tragedies like this from happening again in other communities. As a state, we must do more to address gun violence and keep ourselves, our families, our friends and our neighbors safe,” Cloutier wrote in a statement to the press.

“Words are not enough — they never have been. We must take bold action,” she added.

The Maine Gun Safety Coalition immediately called on state lawmakers to pass an assault weapons ban calling the events in Lewiston “horrific, senseless tragedies.”

Rep. Rebecca Millett (D-Cape Elizabeth), a member of the state’s Gun Safety Caucus, said it was very difficult to talk about the mass shooting in Lewiston, after spending years fighting “bad gun bills” and trying to advance gun safety laws.

“The years I had to listen to my colleagues stand and say we don’t need gun safety legislation and Maine is the safest place in the country. To have my worst nightmares happen, is just devastating,” Millett said in an interview with The Maine Monitor.

Rep. Jared Golden (D) Maine second district Congressman

In another development, US Rep. Jared Golden, a Lewiston Democrat, told a news conference Thursday evening he would drop his opposition to an assault weapons ban that has stalled in Congress.

“I have opposed efforts to ban deadly weapons of war, like the assault rifle used to carry out this crime,” Golden said. “The time has now come for me to take responsibility for this failure, which is why I now call on the U.S. Congress to ban assault rifles, like the one used by the sick perpetrator of this mass killing in my hometown of Lewiston, Maine.”

Details emerge about man alleged to have shot 18 people:

A manhunt was underway Thursday by police to find the man suspected of firing multiple shots at two locations, killing 18 and wounding 13. Photos released by law enforcement show a man carrying a semiautomatic style rifle.

The suspect, Robert R. Card, 40, of Bowdoin, has a history of mental health problems and is a trained firearms instructor, according to the Associated Press.

Card is a petroleum supply specialist and Sgt. 1st Class in the Army Reserve, a spokesperson for the U.S. Army confirmed to the Portland Press Herald Thursday. The spokesperson told the newspaper that Card enlisted in 2002 and has received multiple awards but has not been deployed in combat.

The Sun Journal reported that Card had spent two weeks at a mental health facility this summer. It is unknown if Card was voluntarily admitted or involuntarily committed to the facility.

People who are involuntarily committed to a psychiatric hospital by a district court may not own or possess firearms in Maine, according to state law. Violating the law is a class D misdemeanor crime.

The Associated Press reported Thursday that police took Card for an evaluation in mid-July after military officials grew concerned about his erratic behavior while he was training with the U.S. Army Reserves at the Military Academy at West Point in New York, according to an official who spoke to the AP, on the condition of anonymity because they were not authorized to publicly discuss the information. The official told the AP that military commanders called the New York state police, who took Card to the Keller Army Community Hospital for evaluation.

When asked at a press briefing why Card was able to access a gun despite his reported history of mental health challenges, Mike Sauschuck, commissioner of the Maine Department of Public Safety, said “those are all valid questions and certainly questions that we are looking into now, but not questions that we can answer today,” given the ongoing manhunt.

Maine grapples with foreseeable harm

Maine legislators passed the “yellow flag” law in 2019, that allows police to petition a court to remove guns from a person that a medical expert says presents “a likelihood of foreseeable harm” to themselves or others either because of suicidal or violent threats against others.

The Associated Press reported that Maine’s yellow flag law is weaker than so-called “red flag” laws found in some 20 other states. The Maine law requires police first to get a medical practitioner to evaluate the person and find them to be a threat before police can petition a judge to order the person’s firearms to be seized, the AP said.

It was not clear Thursday if the law came into play regarding the suspect in the Lewiston shooting.

Maine’s yellow flag law is underused, police acknowledge. Maine Public Radio reported that the law was used two dozen times in the first two years it was in effect. Earlier this year, law enforcement noted that the law is “not being used on a regular and responsive basis” and cited a lack of available medical professionals to complete the assessments, according to a report.

Barbara Cardone, spokeswoman for the state judicial branch, said Thursday involuntary commitment orders and petitions under the “yellow flag” law are confidential court records. She declined to say whether any such court records existed for Card.

“All of these kinds of records are confidential, so I cannot provide you with any information,” Cardone wrote.

Edward Davis, who was Boston’s police commissioner during 2013 Marathon bombings, said the weapon in photos released by police appeared to be an assault-style rifle, most likely an AR-15 or an M-4, which is the military version of the AR-15.

Davis, who now runs his own security company, noted that he spends time in Maine and has had tense conversations with Mainers about gun ownership.

“I have guns, but they need to be regulated,” Davis said in an interview with The Maine Monitor.

The suspect in the shootings, Card, has a history of mental health problems. “We should have an absolute prohibition on anybody like that having guns,” Davis said.

Maine will now grapple with how to respond to one of its worst mass casualty events.

Similar shootings have shaken the country, including the 2022, Buffalo grocery store shooting that killed 10, and the 2021, spa shooting spree in Atlanta that killed eight people.

“We continue to monitor the horrific situation in the greater Lewiston area as the manhunt is underway for the person of interest in the Lewiston mass shooting. We grieve for the families of the 18 who were killed and 13 injured in this senseless tragedy,” Maine House Republicans said in a news release on Thursday.

Stephen King, famous Maine horror and science fiction author, said on X, formerly known as Twitter, Thursday morning that these kinds of shootings don’t happen in other countries.

“The shootings occurred less than 50 miles from where I live,” he wrote to his 7 million followers. “I went to high school in Lisbon. It’s the rapid-fire killing machines, people. This is madness in the name of freedom. Stop electing apologists for murder.”

A tired fight for change

Everytown For Gun Safety, a gun safety advocacy group, ranked Maine 25th in the nation in terms of gun laws.

Maine law prohibits any person convicted of a crime and sentenced to a year or more in prison from possessing a firearm. People under a protection from abuse order for harassing, stalking or threatening an intimate partner or child also may not possess a gun.

State lawmakers in recent years have rejected ideas to prohibit people from possessing “rapid-fire modification” devices for guns that increase the number of bullets that can be shot at one time or to require background checks for purchasers at private gun shows.

Maine lawmakers also rejected a proposed background check exemption for people with concealed weapons permits when they go to purchase a firearm, and legislation that would regulate the manufacture, distribution and possession of “untraceable and undetectable” firearms.

A proposal that would allow certain people to carry concealed handguns on school property narrowly failed in the Maine Legislature in June.

Several more pieces of gun legislation are expected to be discussed by lawmakers next year when the Legislature reconvenes in January.

Millett, the lawmaker from Cape Elizabeth, has a bill that would allow a person to bring a civil lawsuit against gun manufacturers for selling “abnormally dangerous” guns, because the product was “most suitable for assaultive purposes” rather than hunting, self-defense or sport, or because it converts a legal firearm into an illegal firearm, or is marketed to minors.

She said in an interview Thursday it is time for legislators to listen to the people they represent and to be proactive about gun safety.

Still, lawmakers will face barriers to getting substantial legislation passed next year while they meet for a short time and with restrictions on the kinds of bills that can be worked on.

“We had a host of bills this past session and a good deal of them didn’t go anywhere,” Millett said. “And now that we’re in the short session there’s a lot less latitude for legislators to put in any new legislation for consideration.”

At least one proposed bill that will go to lawmakers next year would restore gun rights to some people convicted of nonviolent crimes if they are not convicted or any additional crimes and 10 years have passed. Criminal law experts have already raised multiple concerns about how the bill is written.

Ten states, including Massachusetts, Connecticut, and New York, have assault weapons bans.

On the federal level, President Joe Biden again called for a ban on assault weapons following the shooting in Lewiston.

Biden urged Congressional Republicans to work with Democrats to pass a bill that would ban assault weapons and high-capacity magazines. He also called for universal background checks, safe storage of guns and an end to liability immunity for gun manufacturers.

Experiencing justifiable anxiety resulting from mass shooting slaughters

MaineBiz reports by Alexis Wells: For Mainers, a sense of trust and safety has been shattered, while parents may be unsure how to speak to their children about the violence and help them feel safe. Resources are available for those struggling with mental health or trying to cope with loss.

“The Maine Department of Health and Human Services (DHHS) encourages anyone affected by the violence in Lewiston to reach out and connect with behavioral health support,” the department said in a statement.

Senator Angus King newsletter: On Wednesday, October 11, Maine the county were horrified by the terrible news about the deadly tragedy in Lewiston. 

And given that the murder suspect remains unfound, we cannot yet move beyond fear to grief.

Eighteen precious lives were senselessly taken during this shocking act of violence, with more than ten injured for doing nothing more than living their lives on a Wednesday night — and my heart is heavy for the families who are mourning this unthinkable loss.

I took the first flight I could get yesterday morning to do everything in my power to support the Lewiston community and everyone impacted by this tragedy. I met with the Governor, the Mayors of Lewiston and Auburn, city councilors of both cities, first responders and medical professionals — sharing my deepest gratitude for their exhausting work and commitment.

If you are in an area currently under shelter in place orders, I ask that you please stay indoors and report any suspicious behavior to local authorities.

This is a challenging time for everyone who calls this great state home, and I want you to know that my thoughts are with you right now. Maine is a big small town connected by long roads — and in times like these, we go the extra mile to look after one another and give comfort and reassurance in any way we can.

I also want to share a few resources below for anyone in need of support in the wake of this tragedy:

If you are experiencing a medical emergency, please call 911.

If you or someone you know is talking about suicide or feelings of hopelessness, please seek help immediately and call or text 988.

Teens and young adults can text The National Alliance on Mental Illness’ Teen Text Line at (207) 515-8398 for support.

Clinicians, educators, and first responders can call The FrontLine WarmLine at 1-800-769-9819 for support managing the stress of responding to disasters.

And if you are outside of Androscoggin County and looking to help the community during this time, please use this link to find your nearest American Red Cross blood donation location.

Please take care and stay safe,

Angus

Medicaid expansion in Alabama: Stop the bleeding! ~ Echo opinion

Two Birmingham AL legislators call for action to provide access to health care coverage.  An echo opinion originally published in Alabama.com (Al.com) ~ Birmingham lawmakers wrote:

By Alabama Representative Mary Moore & Representative Rolanda Hollis, who each represent the Birmingham area in the Alabama legislature.

Today, more than ever, Alabamians face an uncertain landscape when it comes to access to affordable, quality health care. 

Alabama Governor Kay Ivey has the power to help Alabamians to have access to the Medicaid expansion

This uncertainty causes a great deal of distress for all Alabamians dealing both with their own health issues and those of loved ones. It's also a major issue for us as a state because it has a tremendous financial impact on our citizens and stands in the way of having a healthy workforce.

This is why we are joining our voices and efforts together through the introduction of a resolution urging Governor Kay Ivey to expand Medicaid.

In expanding Medicaid, Governor Ivey has the power to help ensure access to quality healthcare for many Alabamians, particularly, children, seniors and those in our rural communities that rely on the infrastructure that the program provides.

We have seen - and continue to see - the enormous negative impact NOT expanding Medicaid has already had on our state.

It's time to stop the bleeding.

It's time to shore up our rural hospitals and rural healthcare providers instead of contributing to the further decimation of these communities that are so important to our state and the isolation of their residents.

It's time to strengthen this program and others that are so vital to so many of our most vulnerable citizens - from young children to our seniors.

We are also encouraging a thorough review of any and all state-funded mental health services to ensure that such appropriations are spent wisely and provide first-rate care.

We have both a moral and a legal responsibility to provide quality mental health treatment options for Alabamians suffering from mental illness. These struggles touch every part of our citizenry - from our young to old, students to new mothers, to returning veterans.

Failure to meet that commitment with effective programs and adequate funding levels has already led to increased costs in emergency care and incarceration, not to mention the human cost in countless lives devastated and families disrupted. We cannot allow this to continue.

We must support a mental health care delivery system based on evidence-based practices and which is accessible to all citizens, family caregivers, law enforcement personnel, and healthcare providers. Those suffering with these issues, their families and the state deserve nothing less.

We sincerely hope Governor Ivey will take this plea to heart and our colleagues on the other side of the aisle will as well.Together, we can truly make an enormous difference in the lives of so many Alabamians by putting political rhetoric aside and doing what is right.

Senator Ted Cruz Should Pay Damages

It makes no sense to give Senator Ted Cruz any regnition, at all, post this preventable government fiscal crises. 

Senator Ted Cruz is unworthy of any mentions except to reference him with disdain. As a matter of fact, since Senator Cruz was the instigator of this terribly preventable crises, he should bear the brunt of the costs. Like a person who's responsible for preventable damages in a lawsuit, Senator Cruz should pay for the damages he created.

Senator Cruz has endured justifiable scorn from Republican colleagues and even a recall of his newspaper endorsement by the Houston Chronicle. Nevertheless, he continues to experience undue exposure because he pulled off a near coup in a seditious action to stop the American government, just because he could.  

Like an ill person who engages in delusional thinking as a result of cerebral dissociation disorders, his egotistical vision was coupled with an apparent Messianic complex. He was willing to become a sacrificial lamb to prove his cause, regardless of how his fools errand would harm others.  It didn't matter if he failed on his fool's error to eliminate health care reform called Obamacare.

 Senator Cruz obviously didn't consider the people he would harm in his seditious behavior.  He had a vision for causing trouble, regardless of the consequences to average people.

My experience with people who behave pompously is to look for a physiologic etiology, ie a "cause".  

In other words, Senator Cruz's behavior is not normal and he should have a mental evaluation, including drug testing, to determine if he is competent to be a United States Senator.  Meanwhile, he should be held accountable for the damages for his irresponsible behavior.